Wits School of Governance (ETDs)

Permanent URI for this community

https://hdl.handle.net/10539/37944

Browse

Now showing 1 - 10 of 10

Anaysis of the public participation process in the gauteng etolls initiative
(2021) De Freitas, Manuel Simão França
This study analyses the public participation processes led by SANRAL (South African National Roads Agency Limited) within the Gauteng Freeway Improvement Project (GFIP). The public appeared to have been against this project from the beginning claiming that they were not properly consulted on this project. The term public is defined by the Merriam-Webster dictionary “as a group of people having common interests or characteristics”. The common interest in this study was the etolls initiative.
Assessing the impact of covid-19 on monitoring and evaluation functions of the gauteng department of health
(2023) Dlamini, Nqobile Minenhle; Pophiwa, Nedson
The Covid-19 pandemic brought unprecedented challenges that required enforced adaptation in all aspects of human life globally. With such an outbreak the government sector was forced to develop mitigation factors and implement precautionary measures useful for curbing the pandemic. Hence, the research focuses on the Gauteng Department of Health as it is at the forefront of the healthcare sector. The main research objective is to understand ways in which the pandemic disrupts the Gauteng Department of Health’s Monitoring and Evaluation functions mechanisms adopted to ensure function continuity. Therefore, it was also important to understand the tools and mechanisms that were adopted and how the pandemic changed their implementation. A total of 10 key participants within the department were interviewed and a question guide was used as a data collection tool during the interview process. The participants interviewed were purposively sampled as a form of non-probability sampling. This study is a qualitative case study research design with an exploratory research approach. During the interview process, the majority of the participants indicated that lockdowns, restrictions on travel, isolations, quarantines, and the shutdown of non-essential activities were highly implemented. However, these restrictions impacted how raw data was collected in the field. Remote data collection had to be introduced and it became common because face-to-face data collection was limited due to contracting the virus. The findings of this study revealed that the Monitoring and Evaluation practices in the department were no longer treated as a priority due to the urgent response to the pandemic. The data that has been collected throughout the research indicates that there are ways in which Monitoring and Evaluation can be developed and innovated. The study also highlighted the best possible interventions or recommendations that can be taken into consideration should a pandemic of this nature arise in the future. This becomes a contribution to the knowledge gap concerning the disruption of an unexpected pandemic
Assessing the impact of mobile technological innovation on maternal healthcare in South Africa
(2020) Matee, Misha Govind
Background: Maternal mortality is a significant public health issue in developing countries due to its shocking magnitude and lower declining pattern. Identifying determinants and designing intervention will have an important role to overcome the problem. Ending preventable maternal mortality remains one of the world’s most critical challenges despite significant progress over the past decade. These deaths are primarily from preventable causes before, during and after the time of giving birth. (Boerma, et al., 2015) Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. (Kumar, et al., 2013) The rapid growth in access to mobile phones and networks in Africa has created an opportunity for mHealth programs to impact the health of Africans positively. mHealth programs have the potential to contribute to innovative solutions to address health system challenges including (1) disparities in access to health services; (2) inadequacies of health infrastructure; (3) limited human resources for health; (4) cost to the individual of accessing health services; and (5) challenges in health financing. (African Strategies for Health (ASH), 2016) Therefore this study aimed to identify the correlates of mobile technology and maternal mortality in developing countries. Method: This research report conducted used national and international databases of health metrics from 2011 to 2019. Using aggregates of health indicator data from Statistics South Africa (STATSSA), the World Health Organisation (WHO), World Bank, United Nations Development Programme (UNDP) and United Nations International Children's Emergency Fund (UNICEF) databases. Momconnect and Mum & Baby data were collected from Vodacom South Africa, the National Department of Health (NDoH) and Praekelt. The dependent variable was the maternal mortality ratio (MMR). In contrast, the independent variable was the numbers of subscribers for Momconnect and Mum & Baby, two national maternal mobile healthcare applications in South Africa. Data was compiled in excel and analysed using correlation tests and regression analysis. Results: The maternal mortality ratio in South Africa is high. A significant relationship between the maternal mortality ratio and the adoption of mobile healthcare applications was observed. There were an inverse and significant correlation between the maternal mortality ratio and the diffusion of mobile technology. Conclusion: The maternal mortality ratio is correlated with mobile technology.
Assessing the South African National Health Insurance policy process from 2007-2019
(2021) Mangwiro, Neville Taziva
Over a decade has gone by since the National Health Insurance (NHI) policy was put on the policy agenda when the African National Congress (ANC) passed a resolution to implement it. However, much of the discussion has focused on the design/content of the NHI and little attention has been put on the policy process and how it may have influenced the policy outcomes from 2007 to 2019. The purpose of this research is to assess the NHI policy process to examine the relationship between the nature of the process and the resulting policy outcomes. Elements of a systematic rapid review were adopted to conduct this study. The study took the form of a qualitative exploratory case study. Data collection involved document review using search words and various rapid review inclusion and exclusion methods to select documents. A Multiple Streams Framework (MSF) was adopted for the study. The study found that the elitist (top-down) approach taken by the government has been the main reason for the design/content of the NHI policy. Furthermore, the policy proposals themselves are very complex, which naturally slows completion of the process as the technical barriers to implementation become apparent. In large part these technical barriers are reflected through wide-ranging contestation from a significant spectrum of stakeholders. Also, the consultation process failed to meet its objectives, a feature that pervades the entire policy process to date. It was concluded that the NHI has a long way to go and that a more participative approach should be taken
Exploring primary healthcare services for informal workers: a case of South African women informal/ street traders in the City of Johannesburg Region F
(University of the Witwatersrand, Johannesburg, 2023-03) Dube, Duduzile Ellen; Niekerk, Robert Van.
In all humility and gratitude, I am overwhelmed to acknowledge my depth of gratitude to all those who have assisted me in putting this idea, well over the degree of simplicity and into something concrete. I would like to convey my sincere appreciation and gratitude to my esteemed supervisor Professor Robert Van. Niekerk for his invaluable supervision, tutelage, support, and patience in this challenging and interesting research journey from start to finish. Oh, what a journey of discovery Prof. Thank you to the defence panel committee who generously provided knowledge, expertise and most importantly an endorsement to fulfil my research project. My sincere appreciation to the research participants, this project would not have been possible without, izandla zedlula ikhanda. Ngiyabonga kakhulu boMama!!! I also appreciate my cohort colleagues for the late-night feedback sessions and moral support especially Phello, Max and Basil, many thanks’ gents. Thanks, should also go to my lovely CoJ siblings (Nstako, Millicent, Busi and Chester aka my research assistants) for your selflessness during the data collection phase of my research journey. Additionally, a heartfelt thanks to my CoJ principals/ colleagues for your unwavering support and encouragement there is just too many to mention. Thank you for believing in me even at times when all doubt filled my mind, I will remember you for a very long time. A special acknowledgement to Ms Tembeka Mhlekwa former Executive Director, Department of Economic Development (CoJ) for an important and unprovoked talk in 2018 that has led me to this moment, I am forever grateful. I wish to acknowledge the help provided by Mr Elliot Dubasi in putting together the unit of investigation arguably the most important activity in this project. Ngiyabonga!!!
Implementation of the mental health care act in psychiatric hospitals
(2017) Mulutsi, Eva Nkeng
Introduction Mental illness is prevalent in all regions of the world and contributes significantly to premature mortality, high morbidity and loss of economic productivity (Baxter, Whiteford, Vos, & Norman, 2011; Charlson, Baxter, Cheng, Shidaye, & Whiteford, 2016). In South Africa, the Mental Health Care Act (No 17 of 2002) was promulgated in 2004 in response to the high burden of mental illness and to improve mental health service delivery, within a human rights framework. Aims and Objectives: The overall aim of this PhD study was to examine the implementation of the Mental Health Care Act in psychiatric hospitals in South Africa. The specific objectives were to: explore stakeholders’ involvement in the implementation of the Act; examine the policy processes followed in the implementation of the Act; determine whether Mental Health Review Boards execute their prescribed roles and functions; examine the implementation of legal procedures for involuntary admissions of psychiatric patients; and identify factors that influenced the implementation of the Act. Methods: The study was approved by the Human Research Ethics Committee of the University of Witwatersrand, Johannesburg. Sixteen psychiatric hospitals were selected in nine provinces, through stratified random sampling. Using an adapted conceptual framework with policy implementation theory as its foundation, the overall study approach was qualitative in nature, complemented with a record review of involuntary patient admissions in the selected hospitals. The qualitative component consisted of 35 in-depth interviews with: the drafter of the Act (n=1); provincial mental health coordinators (n=9); a psychiatrist at each of the selected hospitals (n=16); and the chair of a Mental Health Review Board in each of the provinces (n=9). At each selected psychiatric hospital, five patient records were selected randomly (n=80), focusing on compliance with the legal procedures for involuntary admissions. The qualitative data were analysed using thematic content analysis and MAXQDA® 11 while STATA® 12 was used to analyse the data from the record reviews. Results: South Africa’s political transition created a window of opportunity for the implementation of the Act. Wide-spread stakeholder support for the spirit and intention of the Act, advocacy for human rights, the broader transformation of the health system, and the need for enhanced governance and accountability in mental health, facilitated the implementation of the Act. However, implementation was hindered by: the relatively low prioritisation of mental health; stigma and discrimination; poor planning and preparation for implementation; resource constraints; and suboptimal stakeholder consultation. The study found that the majority of involuntary psychiatric patients admitted during (the year) 2010 were single (93.8%), male (62.5%), and unemployed (85%), predominantly black African (80%), with a median age of 32.5 years. The primary diagnoses were schizophrenia (33/80), substance-induced psychosis (16/80), bipolar mood disorders (15/80) and acute psychosis (9/80). There was poor compliance with the prescribed procedures for involuntary psychiatric admissions, exacerbated by suboptimal governance by, and functioning of, the Mental Health Review Boards, thus resulting in de facto illegal detention of patients. Conclusion and Recommendations: The Mental Health Care Act is an important policy lever to address the burden of mental illness and ensure quality mental health service delivery in South Africa. However, the enabling potential of the Act can only be realised if the following issues are addressed: improved, and dedicated resources for mental health; training and capacity building of health professionals and hospital managers on key aspects of the Act; improved governance, leadership and accountability through well-functioning Mental Health Review Boards; and improving mental health infrastructure and community-based services.
Measuring equity in public health financing across provinces in South Africa
(2021) Maake, Marumo
The post 1994 government in South Africa has been struggling over the years to address the socio-economic imbalances that existed during the apartheid period. In that period public health services were severely fragmented. While efforts were made over the years to address the inequalities, health indicators suggest that huge challenges still exist. Therefore, this research assesses whether the allocation of public health resources are equitably distributed, using expenditure as a proxy. The methodology used entailed the development of a needs-based formula to measure if the public health expenditure is allocated based population needs across provinces. The formula requires the weighting of the public sector population for its different need factors such as age and sex characteristics, burden of disease and socio-economic indicators such as deprivation indices. The findings of the research revealed that the distribution of public health resources are skewed towards certain provinces. This means that there is an inequitable distribution of health services across provinces and therefore the health allocations are not based on the needs of the population. Critical priority areas such as medicines, medical supplies and laboratory services are worst affected by the skewed distribution.
Perceptions of community care workers on their roles and responsibilities: Soshanguve, Pretoria
(2021) Mawadzwa, Tronny
Care workers play a pivotal role in the community affected by HIV/AIDS through regular home visits. The purpose of this research was to understand better the perceptions of care workers who provide services to HIV/AIDS home visits in the community of Soshanguve. The researcher used research strategy because the study was concerned with collecting data about the care workers’ perceptions and opinions about the services offered to HIV/AIDS-affected individuals and their families. The researcher selected a phenomenology research design for this research to help understand the perceptions and experiences of care workers, and it allowed for an in-depth analysis of the information from a single group of care workers. The researcher used semi-structured interview guides to ask questions in a focus group set up and on individuals as Key Informants’ Interviews (KIIs). A sample of 9 care workers took part in the study, broken down into one focus group with 7 participants and 2 KIIs were conducted as well. The findings from the study indicate that care workers have fragmented roles and responsibilities that are always changing. The working conditions are not safe for their health and safety. Care workers reported that they recognized by higher superiors and are forced to work under harsh weather conditions with tight targets to accomplish every month. Findings indicate that care workers require adequate training and psychosocial support to help them cope with emotional stress. Lastly, the remuneration of care workers has to be revised as data collected showed that the stipend they receive does not sustain their basic living conditions. Care workers have a passion for assisting the government meet their sustainable development goals on HIV/AIDS. For care workers to effectively perform at work, roles and responsibilities have to be fixed, their working conditions improved, provide training and psychosocial support and revise their stipend
Rehabilitation outcomes measurement instruments usage in KwaZulu-Natal and Gauteng healthcare
(University of the Witwatersrand, Johannesburg, 2022) Buthelezi, Mnqobi Basil
There is a lack of rehabilitation outcome data collection and use in South Africa. Important to note in this study discussion are Rehabilitation Outcome Measures which are tools (FIM, BI, MRS, FAI, NEADL) used to collect data and measure the extent of change during and post-rehabilitation period. This research purpose aims to evaluate the awareness, and use of rehabilitation outcome data measuring instruments, the available capacity, opportunities of learning and constraints that exist across different settings in public and private rehabilitation healthcare in KZN and GP. A quantitative research strategy was utilised. A cross-sectional, survey design plan of data collection framework was used. Face-to-face primary data collection was conducted in the proposed research sites. Purposive sampling targeting 13 rehabilitation public-private healthcare facilities in KZN, and GP was used. Stratified sampling together with 100% sampling in a small population was conducted. Community of Rehabilitation Multidisciplinary Teams (RMTs) of seven (7) members in public and private hospitals, composed of medical officer(s), nurse(s), clinical psychologist(s), physiotherapist(s), occupational therapist(s), speech/audio therapist(s) and social worker(s) took part in the study. SPSS assisted in results analysis; frequencies and non-parametric Chi-square of independence statistics were utilised to sort any significant associations. Results indicated that 253 subjects participated in the study. Analysed results suggested that n=153 (60.5%) participants were not provided with rehabilitation outcome measuring tools by the facility they were working for. Results suggested a significant negative association in Public Rural Settings (FIM=49.7%, BI=43.8%, MRS=41.9%, p=0.001, FAI=17.6%, p=0.037) and Public Urban Settings (FIM=43.2%, BI=36.5%, MRS=40.5%, p=0.001 and FAI=35.3%, p=0.037) of public healthcare facilities as they were not using rehabilitation OMs. A significant association in use of rehabilitation OMs was found in Private Urban Rehabilitation Healthcare facilities (FIM=56.0%, BI=35.6%, MRS=64.5%, p=0.001 and FAI=47.1%, p=0.037). Public healthcare facilities in KZN and GP were not using rehabilitation outcome measures, while GP Private rehabilitation healthcare facilities were using them. In conclusion, it is recommended that National Rehabilitation Policy (NRP) is subjected to reviews to incorporate standardisation of rehabilitation OMs. A diagnostic evaluation exercise is necessary for Theory Of Change development focusing on rehabilitation healthcare services
Wits student perceptions and attitudes of the South African National Health Insurance (NHI) policy reform
(2023) Heggenstaller, Alessandra Kim
South African healthcare is practiced within a two-tier system. This sees the public sector as run by government and the private sector which is supported in relation to an individual’s ability to contribute to a medical scheme—which is the main form of health insurance. Due to the absence of adequate coverage for many people in the developing world the World Health Organisation (WHO) has advocated the elimination of these gaps with the ultimate objective being Universal Health Coverage (UHC). This global initiative has been used to frame the rationale for a reconsideration of the South African health system. Their proposed systemic overhaul is broadly referred to as an attempt to achieve a single-payer National Health Insurance (NHI) policy reform (the White Paper, 2017). The primary goal of this policy is to ensure healthcare equity within an ethos of equality is provided to all South Africans. Functioning dynamics associated current South African political structures and agendas have put into question the reasonableness and rationale of NHI. This is particularly the case when reviewing the successes and shortcomings associated the nationalisation of private entities. State-owned Enterprises (SoE) have brought to light numerous limitations in how government maintains national infrastructure and delivers public services. Highlighted features of concern are bureaucratic maladministration, fraudulent and corrupt practices. It is from this point of view that questions are raised regarding the viability of the proposals. The policy proposals involve what appear to be extraordinarily complex interventions which raise questions about their appropriateness in context. Policy deliberations and technical appraisals are largely absent with very few people understanding both the proposals and the policy alternatives. It is within this context that this research seeks to examine how well members of the public understand the proposals—focusing on a relatively well-informed sub-group of university students. The research, therefore, seeks to examine if a relationship exists between tertiary students’ perceptions and attitudes in relation to their sense of knowledgeability in supporting, or even dismissing, the proposed NHI policy reform. Focus is given to students enrolled for the 2021 academic year at the University of Witwatersrand (Wits), Johannesburg, South Africa. The project was ethically approved by the Wits Human Research Ethics Committee (Non-Medical). To establish if a correlation exists between the student’s subjective/intersubjective opinions and his/her/their knowledge base, a mixed methods research design was used. A total of 211 online research survey responses were recorded and a total of 4 semistructured face-to-face interviews were conducted. The results indicate that knowledge transfer influenced how the students perceived and accepted the NHI proposals as well as the healthcare policy reform. Moreover, the terminology used to describe the technical processes related to the NHI Bill impact on how openly the students embraced the health systems change. In broad summary, the students expressed a lack of confidence in governments’ ability to improve the current healthcare sector.

Browse

Browsing Wits School of Governance (ETDs) by SDG "SDG-3: Good health and well-being"

Results Per Page

Sort Options